Acta clinica Croatica
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Acta clinica Croatica · Mar 2013
Access to public healthcare services and waiting times for patients with chronic nonmalignant pain: feedback from a tertiary pain clinic.
Evaluation of healthcare services by patients is an essential component of quality improvement. We studied association between patient satisfaction and accessibility of healthcare services to patients with chronic nonmalignant pain. A hundred patients from the Pain Clinic, Split University Hospital Center, Split, Croatia, completed a 27-item questionnaire about their condition, duration of chronic pain treatment, access to healthcare, waiting times for various healthcare services, and their satisfaction with the pain clinic and health system. ⋯ Negative association was found between waiting time for pain clinic appointment and healthcare system grade (r = -0.34, P = 0.02). Patient suggestions for improving pain clinic were more staff, better approach to each patient, and better organization. In conclusion, access to public healthcare for patients with chronic nonmalignant pain should be better to improve patient satisfaction and provide better care.
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Acta clinica Croatica · Dec 2012
Historical ArticleHistorical survey of ophthalmic echography in Croatia.
The first beginnings of ophthalmic echography in Croatia started at the turn of the 1960s and 1970s. When the two largest medical institutions in Croatia, Sestre milosrdnice University Hospital (former Dr. Mladen Stojanović General Hospital) and Zagreb University Hospital Center, both in Zagreb, were supplied with ultrasonic diagnostic devices, Krautkrimer/ Siemens Echoophthalmograph and Echoophtalmograph 7200 MA Kretz, they had to start using the instruments. ⋯ The first course in ophthalmic echography as continuing medical education at the Zagreb School of Medicine was held in 1992. Ultrasound Division of the Croatian Ophthalmologic Society was organized in 1994 and 1998. The references accompanying this survey includes all papers on ophthalmic ultrasound published in Croatia and some abroad, thus representing Croatian echographic bibliography.
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Acta clinica Croatica · Dec 2012
Stereological survey of the ameliorative effects of sulforaphane and quercetin on renal tissue in unilateral ureteral obstruction in rats.
Hydrostatic pressure, which is the result of urinary tract blockage, initiates renal injuries. The injuries are characterized by tubular dilatation and/or atrophy, tubular cell death, inflammatory process and progressive interstitial fibrosis with loss of renal parenchyma. The aim of this study was to evaluate the ameliorative effects of sulforaphane and quercetin, the two natural compounds that can be found in vegetables, in unilateral ureteral obstruction (UUO). ⋯ Changes in the length of Henle's loop and collecting ducts were not significant. In conclusion, quercetin and sulforaphane were found to be effective in preventing some structural renal damage in the direct obstruction model. Quercetin had a more ameliorative role on renal structures.
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Airway management relates to the period of tracheal intubation, maintenance of endotracheal tube in situ, and finally extubation. Problems related to difficult extubation still pose significant challenge for both anesthesiologists and intensivists. This article reviews current approach to extubation strategy following difficult intubation. Guidelines and algorithm may be helpful in order to ensure safe management of the patient during this delicate period of airway management.
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Management of difficult airway is one of the most challenging tasks for anesthesiologists, and failure of securing it could have fatal consequences. We must be prepared to deal with problems in management of difficult airway at any time. ⋯ An anesthesiologist must be aware of the possibility of both situations to arise and preparations must be taken to deal with such cases and improve the safety of our patients. Practice guidelines are systematically developed recommendations that help anesthesiologists in the management of difficult airway.